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Community-Led Total Sanitation (CLTS) is a revolutionary approach in which communities are facilitated to conduct their own appraisal and analysis of open defecation and take their own action to become open defecation-free. This report presents CLTS approaches in six countries which differ organisationally with contrasting combinations of NGOs, projects and governments. Practical elements in strategies for going to scale have included: training and facilitating; starting in favourable conditions; conducting campaigns and encouraging competition; recruiting and committing teams and full-time facilitators and trainers; organising workshops and cross-visits; supporting and sponsoring Natural Leaders and community consultants and inspiring and empowering children